Chronic Disease

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Patients suffering from arthritis or depression may have worse health-related quality of life than those with other chronic conditions

A new study reveals that 3 out of 5 Americans suffer from at least 1 of 18 chronic health conditions. Of these, arthritis and depression seem to have the most negative impact on health-related quality of life. About half (53 percent) of the people surveyed reported suffering from 1 to 4 of 18 chronic conditions; 10 percent reported having more than 4 of the conditions. Chronic conditions reported by more than 10 percent of the sample were sinusitis (24.8 percent), hypertension (23.5 percent), and arthritis (21. 5 percent), followed by depression, hay fever, migraine headaches, and asthma.

University of Arizona researchers, Yu Ko, M.S., and Stephen Joel Coons, Ph.D., analyzed how adults described and rated their health status on the EQ-5D. The EQ-5D has five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/ depression. Population-based preference weights are applied to the self-reported health state (defined by responses on the five dimensions) to produce the EQ-5D index score.

The EQ-5D index score falls on a scale where 0 = death and 1 = perfect health. The researchers estimated the association between each chronic condition the person reported and the index score, after adjusting for sociodemographic variables. In the second part of the EQ-5D, individuals place their own health on a visual analog scale that runs from worst (0) to best (100) imaginable health state.

While the presence of chronic conditions was associated with a lower EQ-5D index score, higher household income was associated with a higher score. Depression and arthritis were associated with the greatest decrements in the EQ-5D index scores, after accounting for the impact of demographics and other medical conditions. However, the authors suggest caution in interpreting these results, since they did not have data on the severity of the conditions or how well the conditions were managed, which can both affect health-related quality of life. The data analyzed were from a study supported by the Agency for Healthcare Research and Quality (HS10243).

See "Self-reported chronic conditions and EQ-5D index scores in the U.S adult population," by Mr. Ko and Dr. Coons, in the October 2006 Current Medical Research and Opinions 22(10), pp. 2065-2071.